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General NPI Number Information
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NPI Number | 1326954736
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Entity Type | Organization
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Legal Business Name | SCALLION FAMILY MEDICAL CLINIC LLC
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Dates
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Enumeration Date | 08/24/2026
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Last Update Date | 08/24/2026
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Provider Practice Location Address
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Address Line | 125 N MAIN ST
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City | DREW
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State | MS
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Zip | 38737-3406
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Country | US
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Telephone | 662-649-6045
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Fax | 949-875-6984
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Provider Business Mailing Address
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Address Line | PO BOX 243
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City | DREW
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State | MS
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Zip | 38737-0243
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Country | US
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Telephone | 662-649-6045
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Fax | 949-875-6984
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Authorized Official
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Title or Position | OWNER
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Name | BROOKE SCALLION
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Credential | FNP-C
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Telephone | 662-649-6045
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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